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INDEX OF SUSPICION

Andrea C. Bracikowski MD1
Vincent J. Menna MD Gregoy S. Liptak MD1
 1 University of Rochester School of Medicine and Dentistry, Rochester, NY

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page.

We invite readers to contribute case presentations and discussions.

Case 1 Presentation

A 3-week-old boy is referred to the emergency department by his pediatrician for evaluation of a right-sided neck mass discovered by his aunt, also a pediatrician. The baby was born at term after an uncomplicated pregnancy and weighed 9 lb 5 oz. Delivery involved the use of low forceps, but the Apgar scores were 8 and 9 at 1 and 5 minutes. Examination in the emergency department reveals a healthy baby holding his head tilted to the right; he resists rotation to the left. A hard, 2.0- x 3.0-cm mass can be palpated in the distal right sternocleidomastoid muscle. The mass is not tender and is mobile under the skin. There is no erythema.






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Copyright © 1993 by the American Academy of Pediatrics.